Saturated Fat and Cardiovascular Disease: A Review of Current Evidence
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OBESITY AND DIET (G RAO, SECTION EDITOR)
Saturated Fat and Cardiovascular Disease: A Review of Current Evidence Majella O’Keeffe & Marie-Pierre St-Onge
Published online: 27 January 2013 # Springer Science+Business Media New York 2013
Abstract Cardiovascular disease (CVD) is one of the leading causes of death throughout the world. Saturated fatty acids (SFA) have long been implicated in the development of CVD. The evidence to support this hypothesis came from studies which examined the effects of SFA intake on total cholesterol (TC). However, relying on TC as the sole primary outcome may not be sufficient and understanding the effect of SFA on the concentrations of other lipid fractions is necessary. SFA are known to increase low-density lipoprotein cholesterol (LDL-C) and consequently dietary guidelines recommend reducing SFA intakes in order to decrease LDL-C and CVD risk. However, recent evidence suggests that not all SFAs possess the same atherogenic properties but this development has not yet been reflected in dietary recommendations. This review summarizes recent evidence on the relationship between SFA intake and CVD risk. It also explores current dietary guidelines specific to SFA intake and outlines why future guidelines may need to be food- rather than nutrient-specific. Overall, the evidence presented in this review suggests that not all SFA are created equal and the food sources of SFA, as well as individual characteristics of the SFA, such as chain length, should be considered in dietary recommendations. M. O’Keeffe Kings College London, School of Medicine, Diabetes and Nutritional Science Division, SE1 9NH, London, UK M. O’Keeffe : M.-P. St-Onge New York Obesity Nutrition Research Centre, St. Luke’s/Roosevelt Hospital, New York, NY 10025, USA M.-P. St-Onge College of Physicians and Surgeons, Columbia University, New York, NY 10036, USA M.-P. St-Onge (*) New York Nutrition Obesity Research Centre, 1090 Amsterdam Avenue, suite 14D, New York, NY 10025, USA e-mail: [email protected]
Keywords Cardiovascular disease . Saturated fat . Dairy . Meat . Dietary guidelines Abbreviations AHA American Heart Association BOLD Beef Optimal in Lean Diet CHD Coronary heart disease CRP C-reactive protein CVD Cardiovascular disease DASH Dietary Approaches to Stop Hypertension EFSA European Food Safety Authority FFQ Food frequency questionnaire HAD Healthy American Diet HDL-C High-density lipoprotein cholesterol IL-1β Interleukin-1beta IL-6 Interleukin-6 IL-8 Interleukin-8 IFN-γ Interferon gamma IOM Institute of Medicine LDL-C Low-density lipoprotein cholesterol MUFA Mono-unsaturated fatty acid SFA Saturated fatty acids TC Total cholesterol TG Triglycerides TNF-α Tumor necrosis factor-alpha USDA United States Department of Agriculture USDHHS United States Department of Health and Human Services
Introduction Cardiovascular disease (CVD) is a global public health problem. It is the leading cause of death in most developed countries [1] and increased prevalence is now being detected in developing countries [2]. Despite a
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